Metabolic alterations in meningioma reflect the clinical course

Waseem Masalha,Jürgen Beck,Jakob Woerner,Dieter Henrik Heiland,Nils Pompe,Juergen Grauvogel,Karam Daka,Stefan Weber,Marie T Krüger,Oliver Schnell,Daniel Delev

doi:10.1186/s12885-021-07887-5

Abstract

BackgroundMeningiomas are common brain tumours that are usually defined by benign clinical course. However, some meningiomas undergo a malignant transformation and recur within a short time period regardless of their World Health Organization (WHO) grade. The current study aimed to identify potential markers that can discriminate between benign and malignant meningioma courses.MethodsWe profiled the metabolites from 43 patients with low- and high-grade meningiomas. Tumour specimens were analyzed by nuclear magnetic resonance analysis; 270 metabolites were identified and clustered with the AutoPipe algorithm.ResultsWe observed two distinct clusters marked by alterations in glycine/serine and choline/tryptophan metabolism. Glycine/serine cluster showed significantly lower WHO grades and proliferation rates. Also progression-free survival was significantly longer in the glycine/serine cluster.ConclusionOur findings suggest that alterations in glycine/serine metabolism are associated with lower proliferation and more recurrent tumours. Altered choline/tryptophan metabolism was associated with increases proliferation, and recurrence. Our results suggest that tumour malignancy can be reflected by metabolic alterations, which may support histological classifications to predict the clinical outcome of patients with meningiomas.

Highlights

Meningiomas are common brain tumours that are usually defined by benign clinical course
The last subgroup comprised meningiomas that showed a distinct mutation in the POLR2A gene followed by dysregulated RNA synthesis [3, 5]. others suggested that malignant meningiomas have different DNA methylation patterns than other types of meningiomas and that the differently methylated genes could serve as diagnostic biomarkers for malignant transformation [6]
We further identified altered tryptophan metabolism; this amino acid is mainly metabolized by three pathways: the serotonin (5hydroxytryptamine [5-HT]) pathway, the kynurenine (KYN) pathway, and the tryptamine pathway [34]

Summary

Introduction

Meningiomas are common brain tumours that are usually defined by benign clinical course. Some meningiomas undergo a malignant transformation and recur within a short time period regardless of their World Health Organization (WHO) grade. The 2016 World Health Organization (WHO) classification divided meningiomas into three histological grades (I to III) and described 16 histopathological subtypes [2]. These WHO grades have presented a significant correlation with clinical outcomes in several recent studies. A few benign meningiomas (WHO grade I) can transform into an aggressive growth pattern and recur after a short period of time. The importance of TERT promoter mutations and their potential use as biomarkers to identify meningiomas at risk of malignant transformation was reported [7]

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